Hypersensitivity-Cytotoxic Reactions:

Definition:

Cytotoxic type II reactions are started by antibody generally, IgG or IgM reacting with cell bound antigen.

Mechanism of pathogenesis:

IgM or IgG antibodies react with antigen on the surface of cells (i.e., RBC.). This antigen-antibody reaction activates complement cascade. These outcomes in opsonization and phagocytosis and afterward cell death or lysis.

Clinical Features:

Many kinds of cytotoxic reactions can be grouped according to the nature of target cells or tissue damage which takes place in the reaction.

1. Red blood cell lysis is the most significant clinical phenomenon related with cytotoxic reactions. Illustration is incompatible transfusion reactions

Transfusion reactions:

Figure: Mechanism of Transfusion reactions

Haemolytic disease of the new born:

Hemolytic disease of newly born is a potential fatal disease caused by maternal IgG antibodies directed against paternal antigens stated on fetal red blood cells. The common target of this response is the Rh blood group antigen. Maternal anti Rh antibodies cross the placenta to attack the fetal red blood cells. This situation is also termed as erythroblastosis fetalis.

2. Auto immune hemolytic disease:

In this disease, the symptoms contain fever, fatigue, jaundice and splenomegaly due to the existence of antibodies directed against self red blood cell antigens and outcome in anemia.

3. Drug Induced reactions:

• Sedormid [i.e., Sedative] binds to platelets and causes thrombocytopenic purpura.
• Chloramphenicol binds to WBCs and leads to agranulocytosis.
• Phenacetin [i.e., tranquilizer] joins to RBC and induces hemolytic anemia

4. In rheumatic fever antibodies against group A streptococci cross react with the cardiac tissues.

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